BIOCHEMISTRY PROFILES

BIOCHEMISTRY, which is also known as clinical chemistry, is the area concerned with the analysis of bodily fluids (urine, blood etc.) to determine the presence/activity of defined molecules. Biochemistry tests may be sub-categorized into: 1. General biochemistry 2. Endocrinology 3. Immunology 4. Pharmacology

This section includes general biochemistry profiles to provide information for the following conditions / organs:

MYELOMA is a hematological malignancy (blood cancer) of plasma cells (cells of the immune system) in bone marrow that produce antibodies. Testing for Myeloma may be performed to diagnose the disease, monitor disease progression / effectiveness of treatment or detect any possible complications.

DIABETES is a condition characterized by hyperglycemia (high blood sugar). This is usually due to insufficient levels of insulin. Common symptoms include: polyuria (excessive urine production), polydipsia (increased thirst) and vision problems. Currently there exist three main forms of Diabetes: 1. Type I 2. Type II 3. Gestational Diabetes

OSTEOPOROSIS is a condition where bones become softer thus increasing the chances of bone fracture. Osteoporosis is more common in post-menopausal women but it may also develop in men. In addition, osteoporosis may arise as a result of certain drug therapies (e.g. steroids) or in the presence of hormonal disorders.

LIVER FUNCTION tests are performed to aid in the diagnosis of liver diseases such as hepatitis, cirrhosis and cancer amongst others. These tests include liver enzymes, bilirubin and total protein to name a few.

LIPID PROFILE tests are performed to determine a persons risk for coronary heart disease. These tests will help determine whether someone is at risk of having blocked blood vessels that can lead to a heart attack or a stroke. These tests include total cholesterol, HDL (referred to as the good cholesterol), LDL (referred to as the bad cholestrol) and triglycerides. Based on the results the atherogenic ratio is calculated to determine risk of atherogenesis.

LIPOPRINT LDL Subfraction Profile

Is your lipid profile really normal?

The Lipoprint LDL test identifies and measures the small LDL subfractions associated with increased risk of heart disease.

The color coded test profile is easy to interpret..showing the large “normal” LDL in yellow, the small “bad” LDL associated with heart disease in red, and the “good” protective HDL in green.

“Normal” Low Risk Profile

“Abnormal” High Risk Profile

Benefits of the Lipoprint Test  Assists the doctor in identifying individuals at risk for heart disease that may be missed by traditional cholesterol tests  Since different LDL profiles may require different treatment, Lipoprint LDL can assist the doctor in determining the best diet and / or drug treatment for the patient  Assists the doctor in monitoring the effectiveness of the treatment during follow-up

Recent Findings Medical studies have found that there are seven different kinds of LDL cholesterol particles (subclasses) that could indicate different risk for developing heart disease

Large LDL particles (subfractions 1 and 2 – “normal profile”) do not pose the same risk of heart disease as the small LDL particles (subfractions 3 through 7 – “abnormal profile”) associated with a three time higher risk for developing heart disease

The presence of small LDL subfractions could increase the risk of heart disease even if the total cholesterol and LDL cholesterol numbers are normal

What to do If you have been identified as being at risk for heart disease, have a family history of heart disease, hypertension, diabetes, metabolic syndrome or obesity, are a male over the age of 45 or a female over 55, you should consult your doctor to determine if you could benefit from a Lipoprint LDL test

Test requirements A simple fasting blood sample is required. Do not eat for 12 hours prior to giving blood for this test

FAECAL CALPROTECTIN measurement is a test for inflammatory bowel disease. It replaces the need for invasive colonoscopy or radio-labelled white cell scanning in many clinical scenarios.

Structure and function Calprotectin is a 36kDa calcium and zinc binding protein. It accounts for 60% of neutrophils cytosol. In vitro studies show it has bacteriostatic and fungistatic properties. It is resistant to enzymatic degradation, and can be easily measured in faeces. Use as a surrogate marker Inflammatory bowel diseases (IBD) are a group of conditions that cause a pathological inflammation of the bowel wall. Neutrophils influx into the bowel lumen as a result of the inflammatory process. Measurement of faecal calprotectin has been shown to be strongly correlated with 111 –indium-labelled leucocytes- considered the gold standard measurement of intestinal inflammation.

The main diseases that cause an increased excretion of faecal calprotectin are Crohn’s disease, ulcerative colitis and neoplasms (cancer). Levels of faecal calprotectin are normal in patients with irritable bowel syndrome (IBS).

Specific indications for measuring calprotectin are in: Identify organic bowel disease against functional bowel disease (IBS), and thus avoid the need for invasive tests such as colonoscopy.

 Assessing efficacy of IBD treatments  Predicting relapses or flares of IBD  Offer an alternate diagnostic test for patients phobic of needles or endos

BIOCHEMISTRY

Useful Websites for additional Information: 1. For more information on Myeloma visit the Multiple Myeloma Research Foundation at: http://www.multiplemyeloma.org/ 2. For more information on Diabetes visit the American Diabetes Association at: http://www.diabetes.org/about-diabetes.jsp 3. For more information on osteoporosis and bone health visit the National Osteoporosis foundation at: http://www.nof.org/ 4. For more information on liver diseases visit MedlinePlus at: http://www.nlm.nih.gov/medlineplus/liverdiseases.html 5. For more information on specific lab tests visit Lab tests online at: http://www.labtestsonline.org/understanding/index.html

BIOCHEMISTRY PROFILES

LIVER FUNCTION MYELOMA SCREEN BONE SCREEN TESTS 1

FBC and ESR Urea and Electrolytes ALP (Αλκ. Φωσφατάση) Biochemistry Profile Alkaline Phosphatase SGTP (ALT) Protein Electrophoresis Total Protein SGOT (AST) Immunoglobulins Albumin γGT (IgA, lgG, IgM) Globulin T. BILIRUBIN (Χολερυθρίνη) Bence -Jones Protein Calcium BILIRUBIN DIRECT 24 hour urinary calcium INDIRECT BILIRUBIN 24 hour urinary phosphate

OSTEOPOROSIS

DIABETIC PROFILE SCREEN

Glucose Alkaline Phosphatase LIVER FUNCTION Glycosylated Hb Calcium TESTS 2 Microalbumin Albumin Phosphate

Serum Crosslaps ALP (Αλκ. Φωσφατάση) Vitamin D (25 OH) SGTP (ALT) SGOT (AST) γGT T. BILIRUBIN (Χολερυθρίνη) IRON STATUS BILIRUBIN DIRECT INDIRECT BILIRUBIN PROTEIN ALBUMIN Iron GLOBULIN Total Iron Binding Capacity LIPID PROFILE LDH Ferritin CHOLESTEROL (Χοληστερόλη) HDL-CHOLESTEROL LDL-CHOLESTEROL TRIGLYCERIDES (Τριγλυκ.) ATHEROGENIC RATIO LDL subfractions (lipoprint)